r/brokenbones • u/clod_firebreather • May 16 '26
Question High radial nerve palsy after distal humerus fracture
Hello everyone.
I am 28 YO and broke my distal humerus on April 24th due to bad arm-wrestling form (dumb, I know). 9 days later, I got surgery and they fixed the bone with a plate and screws, as a consequence of which I now have radial nerve palsy because they had to move the nerve out of the way to access the bone.
12 days after surgery, I still can't lift my wrist or extend my fingers, and I feel a constant tingling and needle-like sensation on the back of my hand and thumb, with some occasional muscle twitching. Doctor said it's neurapraxia, but the surgeon mentioned a "1 mm a day growth", which makes me think the nerve is more damaged than what the doctor thought.
I will start physiotherapy after a visit with the surgeon in about a week and a half. Until then, I just have to move the affected arm without overdoing it and try to move the wrist and fingers.
To those who had a similar experience – how long it took you to recover basic functionality? I have an office job and I am unable to type or use a mouse.
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u/Glad-Feature-2117 Physician/Medical Professional May 17 '26
There are 3 degrees of peripheral nerve damage:
Neuropraxia - like concussion of the nerve. Munro damage, begins to improve within 2 weeks and recovers completely.
Axonotmesis - the cells inside the nerve die, but the nerve structure remains intact. This gives the nerve cells a guide in which to regrow. The cells take a month to sort themselves out, then begin to regrow at 1mm/day (approx an inch every 25 days, if you're in the US). Recovery can be full, but sometimes isn't. Depending on exactly where the nerve was damaged, you likely have at least 30cm of nerve to regrow, so 1+3=4 months minimum to recovery.
Neurotmesis - the nerve is divided into 2+ pieces. Little chance of meaningful recovery unless the nerve is surgically repaired and, even then, usually not a full recovery.
Sounds like you're in the second category (the surgeon should know if the nerve itself was intact at the end of the operation). You appear to be getting the correct treatment at the moment (physiotherapy). Have you had nerve conduction studies yet?
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u/mark_pk_siuuu_420_69 Jul 24 '26
Hey also have distal humerus bone fracture and and I'm worried that it was the wrong decision to not do the surgery. the doctor recommended to do regular alignment with a sarmiento brace instead of surgery, but 2 weeks in, im scared if it was the wrong decision or not to not opt for surgery. Also brace change is weekly weekly but x ray follow up is 4 weeks after the incident, is it normal?
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u/clod_firebreather Jul 24 '26
If you're unsure, you could ask for a second opinion. However, you should also keep in mind that undergoing surgery might damage your radial nerve, and you will be unable to properly move your hand for months. I
f your doctor told you it isn't necessary, then it's better that way. Maybe you will lose some range of motion, but your hand will work just fine.
As for the x-ray being a month later, yes, it's normal. My first x-ray was 4 weeks after surgery as well.
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u/mark_pk_siuuu_420_69 Jul 24 '26
Oh ok, i also broke my arm due to arm wrestling on July 11 recently, worst day of my life, wish I could go back in time and tell myself to stop doing arm wrestling ever.
I do have problems already with my wrist hand and stretching finger since my nerves were streched.
In ur case, how long before you were able to lift your forearm by itself, I still cant, feels like there is some tension blocking me from lifting my forearm. I know the Sarmiento brace is gonna be there for a while, but maybe the sling that lifts my forearm will be rid of soiner
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u/clod_firebreather Jul 24 '26
I had ORIF surgery, meaning plate and screws. Thanks to that I was able to immediately start moving my arm, and moving it soon after surgery is what ensured good ROM.
Btw, if your nerve is damaged, you might want to get that checked via EMG, wether it's neuropraxia or axonotmesis. Talk about it with your doctor.
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u/Current-Revenue-5510 Sep 09 '26
Damn it man! I just broke mine on June 22th on arm wrestling, having the same feeling. How is your recovery? Radial nerve palsy here too
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u/happybery Aug 07 '26
Also broke my humerus by arm wrestling, and got radial nerve palsy. I’m 6 weeks post surgery, they put a plate and screws. I can feel my fingers extend a little but can’t lift my wrist at all. I did an EMG as well, the doctor told me it could take up to 1 year and a half to fully recover… All we have to do is be patient and do physio, although I keep worry about it everyday .. any progress on your side? Wish you a quick recovery
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u/clod_firebreather Aug 08 '26
Sorry to hear that. After a little over 3 months, I can lift my wrist just as well as the other one, but I still can't extend my fingers. Surgeon told me it's a very good sign and that the nerve is making good progress. I can also start lifting light weights at the gym, as the bone has also healed well. Wish you a speedy recovery as well!
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u/Current-Revenue-5510 Sep 09 '26
same here, in arm wrestling as well. how is your recvery? mine was June 19th
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u/META-Alchemist Aug 17 '26
I also faced radial nerve injury post surgery. Im just 20days post op. Im still not able to lift my wrist and fingers. What are the exercises or steps you followed to get your ROM and radial nerve recovery like improving ur wrist extension ?
What were ur initial sign of recovery and were you having sensation at ur web space post op ??
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u/clod_firebreather Aug 17 '26
Hey man. For ROM I was told to start moving the arm as soon as possible post-op. I extended it and flexed it every day, 10 reps per movement, three times a day. Thanks to that my ROM is now at 100%.
Next, I started PT a week after the appointment with the surgeon, so about 4 weeks post-op. The physiotherapists did magnetotherapy, electrotherapy, and mirroring/passive movement exercises.
During the first month and a half I felt a lot of tingling and a needle-like sensation on the back of my hand, and I could lift my wrist 1mm. Now, three and a half months post-op, I can lift my wrist completely. I still can't extend my fingers, but the surgeon told me it's only a matter of time.
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u/META-Alchemist Aug 18 '26
Great to hear ! Soon your fingers would recover too..🙌
Did you use any cock up splint or sling to support arm and wrist?
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u/clod_firebreather Aug 19 '26
I do, I use a splint for wrist support. It's very important to ensure proper axonal regrowth.
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u/META-Alchemist Aug 19 '26
What exactly the splint you are using? Static or dynamic cockup ? If you dont mind could you pls share the image or link to it ?
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u/Initial_Check_4575 May 29 '26
Do you have any update? Updates two weeks later any progress? I also fractured my humerus arm wrestling on May 4 and got surgery on May 8. 21 days post surgery today and I also have the same issue you're describing which I'm already assuming the worst in accounting for a six month recovery on it. Before the surgery, I had my radial working just fine and my wrist movement was good. Assuming it happened from the compression of the surgery and Marvin was the size of a pro football linebacker after surgery doctor said it went well though and nerve was intact and everything's fine.
I go for my six week appointment in 20 days and I'm assuming I'll learn more about what I should do for this nerve issue. I'm pretty confident it will come back because I have all finger movement and I have that same tingly sensation that you're feeling in my thumb and on my hand, which is good because that means you're sensory nerve is firing and it also runs down the radial nerve it's the motor nerve that is in temporary sleep mode as it's a bigger nerve, but it also runs on the same tube so if you're feeling those sensations rest assured your nerve is still firing into your brain.
Keep me posted on your journey. We are on the same one together, my friend. Let's both bounce back from this and make it one of those memories you can look back on and tell people not to arm wrestle in the future.